Secondary organising pneumonia associated to COVID-19 infection in patients with central nervous system inflammatory demyelinating diseases treated with anti-CD20 therapies.

This article focuses on characterizing COVID-19-associated organizing pneumonia (OP) in patients with central nervous system inflammatory demyelinating diseases (IDDs) treated with anti-CD20 therapies, specifically rituximab and ocrelizumab. In a retrospective cohort of 19 patients (mostly with multiple sclerosis), recurrent fever and distinctive chest CT patterns were common, with most requiring hospitalization but no fatalities reported. Diagnosis often involved bronchoalveolar lavage PCR testing and, in some cases, lung biopsy, while treatment combined corticosteroids, antivirals, and convalescent plasma, leading to clinical and radiological improvement in nearly all patients. The study also observed significant decreases in immunoglobulin G (IgG) levels during infection and noted that COVID-19-associated OP should be considered in anti-CD20-treated patients presenting with persistent respiratory symptoms and characteristic imaging findings.